Issue with the esophageal phase of swallowing

• esophagus → LES → stomach
• requires unobstructed esophagus, normal/coordinated peristalsis (esophageal motility) and proper relaxation of the LES

Key symptoms

• Retrosternal localization
• food sticks following initiation of swallowing
• Heartburn
• Food Regurgitation
• CP - Chest Pain
• Weight loss

History

1. Solid or liquid?

2. Intermittent or progressive

3. Associated symptoms?

   

Key Etiology

• Solid food → often a mechanical problem
• Solid & Liquid → often a mobility problem
• Other causes
  • Esophagitis (Radiation, Pill)
  • extrinsic compression
    • benign or malignant mass in the thorax
    • vascular structure

Investigation